Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - A bivariate Bayesian dose-finding procedure applied to a seamless phase I/II trial in rheumatoid arthritis
AU - Thygesen, Helene
AU - Dragalin, Vlad
AU - Whitehead, Anne
AU - Whitehead, John
PY - 2012/11
Y1 - 2012/11
N2 - We describe a dose escalation procedure for a combined phase I/II clinical trial. The procedure is based on a Bayesian model for the joint distribution of the occurrence of a dose limiting event and of some indicator of efficacy (both considered binary variables) making no assumptions other than monotonicity. Thus the chances of each outcome are assumed to be nondecreasing in dose level. We applied the procedure to the design of a placebo-controlled, sequential trial in rheumatoid arthritis, in each stage of which patients were randomized between placebo and all dose levels that currently appeared safe and non-futile. Based on data from a pilot study, we constructed five different scenarios for the dose-response relationships under which we simulated the trial and assessed the performance of the procedure. The new design appears to have satisfactory operating characteristics, and can be adapted to the requirements of a range of trial situations.
AB - We describe a dose escalation procedure for a combined phase I/II clinical trial. The procedure is based on a Bayesian model for the joint distribution of the occurrence of a dose limiting event and of some indicator of efficacy (both considered binary variables) making no assumptions other than monotonicity. Thus the chances of each outcome are assumed to be nondecreasing in dose level. We applied the procedure to the design of a placebo-controlled, sequential trial in rheumatoid arthritis, in each stage of which patients were randomized between placebo and all dose levels that currently appeared safe and non-futile. Based on data from a pilot study, we constructed five different scenarios for the dose-response relationships under which we simulated the trial and assessed the performance of the procedure. The new design appears to have satisfactory operating characteristics, and can be adapted to the requirements of a range of trial situations.
KW - dose finding
KW - bivariate outcome
KW - phase I/II trial
KW - Bayesian methods
KW - safety monitoring
KW - futility
U2 - 10.1002/pst.1539
DO - 10.1002/pst.1539
M3 - Journal article
VL - 11
SP - 476
EP - 484
JO - Pharmaceutical Statistics
JF - Pharmaceutical Statistics
SN - 1539-1604
IS - 6
ER -